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For decades, the story of tobacco and the heart seemed settled. Cigarettes were dangerous because they burned, releasing tar, carbon monoxide, and thousands of toxic chemicals that wrecked blood vessels. Remove the fire, the thinking went, and you remove almost all of the danger. That's the logic behind heat-not-burn devices, e-cigarettes, and now nicotine pouches, each marketed, in turn, as the "safer" next step for people who can't or won't quit nicotine altogether.
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